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Risk Factors for Peripheral Artery Disease (PAD)

It is possible to develop PAD with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing PAD. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

Factors That Can Be Modified or Changed


Smoking irritates and narrows blood vessels, contributes to the buildup of arterial plaque, and raises heart rate and blood pressure. PAD risk is 4 times higher in smokers and former smokers. PAD, which develops over time, can also appear up to 10 years earlier in smokers compared to nonsmokers.

Physical Inactivity

Physical inactivity decreases the health of your blood vessels and cardiovascular system. It also increases the chance of other PAD risk factors such as hypertension, high cholesterol, and diabetes.

Talk to your doctor before you start any exercise program and gradually increase your intensity.

Chronic Health Conditions

High Cholesterol

Cholesterol is a waxy substance crucial to many body processes. The body produces cholesterol and some also comes from your diet. High levels of certain cholesterol in your blood can lead to atherosclerosis, the main cause of PAD.


Blood pressure is the force of blood on arterial walls. High blood pressure, known as hypertension, can cause excess stress on blood vessel walls and turbulent blood flow. Over time, this excess force causes blood vessel damage, and increases the risk of PAD. If you have hypertension, talk with your doctor about monitoring and managing your blood pressure.

Glucose Intolerance

Glucose intolerance and diabetes are metabolic disorders in which the body does not produce or effectively use insulin. Insulin is a hormone that helps pull glucose out of the blood and into cells for use. High levels of glucose in the blood can contribute to atherosclerosis and blood vessel damage. Management of glucose levels can help decrease the risk of arterial diseases like PAD.

Obesity and Overweight

Obesity and overweight is often associated with other factors such as hypertension, high cholesterol, and type 2 diabetes. However, they are still associated with an increased risk of PAD even if you have no other risk factors. Talk to your doctor about your ideal weight range and a plan to help you reach your weight goal.

Metabolic Syndrome

Metabolic syndrome is a condition marked by elevated blood pressure, cholesterol, blood glucose, and body weight, especially excess weight around the midsection. Those with metabolic syndrome have an increased risk of PAD because of excess stress on their cardiovascular system.

HIV Infection

People with long term HIV infection may have an increased risk of PAD. The link between the 2 is unclear.

Factors That Cannot Be Changed    TOP


PAD and atherosclerosis develop over time, which means the older you are, the greater the buildup may be. The heart and blood vessels also have normal changes that can affect function, such as an increase in heart size, slower heart rate, and stiffer blood vessels and valves. This decrease is generally not enough to cause problems on their own, but can cause problems when they combine with current vascular diseases, like PAD.


Men have a higher risk of cardiovascular disease over all, but women's risk increases dramatically after menopause. Estrogen is thought to have some protective role for blood vessels in premenopausal years. The natural decrease in estrogen after menopause can decrease this protection , which brings risk levels similar to those of men. As a result, men tend to develop PAD earlier than women.

PAD is more likely to occur in men over the age of 40, and in women over the age of 50.


Your genes can also determine your risk of PAD with or without other risk factors listed here. Your risk of developing PAD increases if you have a family history of PAD, hypertension, or high cholesterol.



Hills AJ, Shalhoub J, et al. Peripheral arterial disease. Br J Hosp Med (Lond). 2009;70(10):560-565.
Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 11, 2016. Accessed September 23, 2016.
Understanding your risk for PAD. American Heart Association website. Available at:
...(Click grey area to select URL)
Updated April 6, 2016. Accessed June 13, 2016.
Who is at risk for peripheral arterial disease? National Heart, Lung, and Blood Institute website. Available at:
...(Click grey area to select URL)
Updated November 16, 2015. Accessed June 13, 2016.
6/29/2018 DynaMed Plus Systematic Literature Surveillance
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Beckman JA, Duncan MS, Alcorn CW, et al. Association of HIV infection and risk of peripheral artery disease. Circulation. 2018 Mar 13 [Epub ahead of print].
Last reviewed June 2016 by Michael J. Fucci, DO, FACC
Last Updated: 6/29/2018


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